To date, several studies were conducted to find which procedure is superior to the others for the treatment of cervical myelopathy. The goal of surgical treatment should be to decompress the nerves, restore the alignment of the vertebrae, and stabilize the spine. Consequently, the treatment of cervical degenerative disease can be divided into decompression of the nerves alone, fixation of the cervical spine alone, or a combination of both. Posterior approaches have historically been considered safe and direct methods for cervical multisegment stenosis and lordotic cervical alignment. On the other hand, anterior approaches are indicated to the patients with cervical compression with anterior factors, relatively short-segment stenosis, and kyphotic cervical alignment. Recently, posterior approach is widely applied to several cervical degenerative diseases due to the development of various instruments. Even if it were posterior approach or anterior approach, each would have its complication. There is no Class I or II evidence to suggest that laminoplasty is superior to other techniques for decompression. However, Class III evidence has shown equivalency in functional improvement between laminoplasty, anterior cervical fusion, and laminectomy with arthrodesis. Nowadays, each surgeon tends to choose each method by evaluating patients’ clinical conditions. 1. Introduction Cervical degenerative disease can result in manifestations distinct from degenerative disease of extremities. The cervical vertebrae contain the spinal cord; its compression by means of deteriorated cervical spine may lead to a generalized debility that sometimes culminates in tetraparesis as well as significant pain. When symptoms do not respond to conservative treatment, surgical treatment is considered. The goal of surgical treatment should be to decompress the nerves, restore the alignment of the vertebrae, and stabilize the spine. Consequently, the treatment of cervical degenerative disease can be divided into decompression of the nerves alone, fixation of the cervical spine alone or a combination of both. In addition, it can be divided into anterior or posterior procedures in terms of approach to the cervical spine. The purpose of this paper is to review the features of the operative treatment of cervical degenerative disease and outline the advantages and disadvantages of each approach and technique. 2. Posterior Approach Posterior approaches have historically been considered safe and direct methods for cervical compression myelopathy with favorable clinical outcomes without fatal
References
[1]
S. N. Bishara, “The posterior operation in treatment of cervical spondylosis with myelopathy: a long-term follow-up study,” Journal of Neurology Neurosurgery and Psychiatry, vol. 34, no. 4, pp. 393–398, 1971.
[2]
A. Casotto and P. Buoncristiani, “Posterior approach in cervical spondylotic myeloradiculopathy,” Acta Neurochirurgica, vol. 57, no. 3-4, pp. 275–285, 1981.
[3]
J. A. Epstein, Y. Janin, R. Carras, and L. S. Lavine, “A comparative study of the treatment of cervical spondylotic myeloradiculopathy. Experience with 50 cases treated by means of extensive laminectomy, foraminotomy, and excision of osteophytes during the past 10 years,” Acta Neurochirurgica, vol. 61, no. 1–3, pp. 89–104, 1982.
[4]
C. A. Fager, “Results of adequate posterior decompression in the relief of spondylotic cervical myelopathy,” Journal of Neurosurgery, vol. 38, no. 6, pp. 684–692, 1973.
[5]
K. Gorter, “Influence of laminectomy on the course of cervical myelopathy,” Acta Neurochirurgica, vol. 33, no. 3-4, pp. 265–281, 1976.
[6]
P. Guigui, M. Benoist, and A. Deburge, “Spinal deformity and instability after multilevel cervical laminectomy for spondylotic myelopathy,” Spine, vol. 23, no. 4, pp. 440–447, 1998.
[7]
Y. Ishida, K. Suzuki, K. Ohmori, Y. Kikata, and Y. Hattori, “Critical analysis of extensive cervical laminectomy,” Neurosurgery, vol. 24, no. 2, pp. 215–222, 1989.
[8]
G. J. Kaptain, N. E. Simmons, R. E. Replogle, and L. Pobereskin, “Incidence and outcome of kyphotic deformity following laminectomy for cervical spondylotic myelopathy,” Journal of Neurosurgery, vol. 93, no. 2, pp. 199–204, 2000.
[9]
Y. Kato, M. Iwasaki, T. Fuji, K. Yonenobu, and T. Ochi, “Long-term follow-up results of laminectomy for cervical myelopathy caused by ossification of the posterior longitudinal ligament,” Journal of Neurosurgery, vol. 89, no. 2, pp. 217–223, 1998.
[10]
S. Matsunaga, T. Sakou, and K. Nakanisi, “Analysis of the cervical spine alignment following laminoplasty and laminectomy,” Spinal Cord, vol. 37, no. 1, pp. 20–24, 1999.
[11]
Y. Mikawa, J. Shikata, and T. Yamamuro, “Spinal deformity and instability after multilevel cervical laminectomy,” Spine, vol. 12, no. 1, pp. 6–11, 1987.
[12]
J. K. Ratliff and P. R. Cooper, “Cervical laminoplasty: a critical review,” Journal of Neurosurgery, vol. 98, no. 3, pp. 230–238, 2003.
[13]
H. N. Herkowitz, “Cervical laminaplasty: its role in the treatment of cervical radiculopathy,” Journal of Spinal Disorders, vol. 1, no. 3, pp. 179–188, 1988.
[14]
T. C. Ryken, R. F. Heary, P. G. Matz et al., “Cervical laminectomy for the treatment of cervical degenerative myelopathy,” Journal of Neurosurgery, vol. 11, no. 2, pp. 142–149, 2009.
[15]
K. Hirabayashi and K. Satomi, “Operative procedure and results of expansive open-door laminoplasty,” Spine, vol. 13, no. 7, pp. 870–876, 1988.
[16]
Y. Ogawa, Y. Toyama, K. Chiba et al., “Long-term results of expansive open-door laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine,” Journal of Neurosurgery, vol. 1, no. 2, pp. 168–174, 2004.
[17]
Y. Saruhashi, S. Hukuda, A. Katsuura, K. Miyahara, S. Asajima, and K. Omura, “A long-term follow-up study of cervical spondylotic myelopathy treated by 'French window' laminoplasty,” Journal of Spinal Disorders, vol. 12, no. 2, pp. 99–101, 1999.
[18]
M. Iwasaki, Y. Kawaguchi, T. Kimura, and K. Yonenobu, “Long-term results of expansive laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine: more than 10 years follow up,” Journal of Neurosurgery, vol. 96, no. 2, pp. 180–189, 2002.
[19]
Y. Kawaguchi, M. Kanamori, H. Ishihara, K. Ohmori, H. Nakamura, and T. Kimura, “Minimum 10-year followup after en bloc cervical laminoplasty,” Clinical Orthopaedics and Related Research, no. 411, pp. 129–139, 2003.
[20]
E. Wada, S. Suzuki, A. Kanazawa, T. Matsuoka, S. Miyamoto, and K. Yonenobu, “Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy: a long-term follow-up study over 10 years,” Spine, vol. 26, no. 13, pp. 1443–1447, 2001.
[21]
P. G. Matz, P. A. Anderson, M. W. Groff et al., “Cervical laminoplasty for the treatment of cervical degenerative myelopathy,” Journal of Neurosurgery, vol. 11, no. 2, pp. 157–169, 2009.
[22]
K. Kohno, Y. Kumon, Y. Oka, S. Matsui, S. Ohue, and S. Sakaki, “Evaluation of prognostic factors following expansive laminoplasty for cervical spinal stenotic myelopathy,” Surgical Neurology, vol. 48, no. 3, pp. 237–245, 1997.
[23]
Y. Handa, T. Kubota, H. Ishii, K. Sato, A. Tsuchida, and Y. Arai, “Evaluation of prognostic factors and clinical outcome in elderly patients in whom expansive laminoplasty is performed for cervical myelopathy due to multisegmental spondylotic canal stenosis. A retrospective comparison with younger patients,” Journal of Neurosurgery, vol. 96, no. 2, pp. 173–179, 2002.
[24]
T. Yamazaki, K. Yanaka, H. Sato et al., “Cervical spondylotic myelopathy: surgical results and factors affecting outcome with special reference to age differences,” Neurosurgery, vol. 52, no. 1, pp. 122–126, 2003.
[25]
C. C. Edwards II, J. G. Heller, and D. H. Silcox III, “T-saw laminoplasty for the management of cervical spondylotic myelopathy: clinical and radiographic outcome,” Spine, vol. 25, no. 14, pp. 1788–1794, 2000.
[26]
S. I. Kihara, T. Umebayashi, and M. Hoshimaru, “Technical improvements and results of open-door expansive laminoplasty with hydroxyapatite implants for cervical myelopathy,” Neurosurgery, vol. 57, no. 4, pp. 348–355, 2005.
[27]
A. Seichi, K. Takeshita, I. Ohishi et al., “Long-term results of double-door laminoplasty for cervical stenotic myelopathy,” Spine, vol. 26, no. 5, pp. 479–487, 2001.
[28]
T. Shiraishi, K. Fukuda, Y. Yato, M. Nakamura, and T. Ikegami, “Results of skip laminectomy—minimum 2-year follow-up study compared with open-door laminoplasty,” Spine, vol. 28, no. 24, pp. 2667–2672, 2003.
[29]
S. J. Wang, S. D. Jiang, L. S. Jiang, and L. Y. Dai, “Axial pain after posterior cervical spine surgery: a systematic review,” European Spine Journal, vol. 20, pp. 185–194, 2011.
[30]
K. Takeuchi, T. Yokoyama, S. Aburakawa et al., “Axial symptoms after cervical laminoplasty with C3 laminectomy compared with conventional C3-C7 laminoplasty: a modified laminoplasty preserving the semispinalis cervicis inserted into axis,” Spine, vol. 30, no. 22, pp. 2544–2549, 2005.
[31]
K. Satomi, J. Ogawa, Y. Ishii, and K. Hirabayashi, “Short-term complications and long-term results of expansive open-door laminoplasty for cervical stenotic myelopathy,” Spine Journal, vol. 1, no. 1, pp. 26–30, 2001.
[32]
K. Yonenobu, N. Hosono, M. Iwasaki, M. Asano, and K. Ono, “Laminoplasty versus subtotal corpectomy: a comparative study of results in multisegmental cervical spondylotic myelopathy,” Spine, vol. 17, no. 11, pp. 1281–1284, 1992.
[33]
H. Sakaura, N. Hosono, Y. Mukai, T. Ishii, and H. Yoshikawa, “C5 palsy after decompression surgery for cervical myelopathy: review of the literature,” Spine, vol. 28, no. 21, pp. 2447–2451, 2003.
[34]
K. Chiba, Y. Toyama, M. Matsumoto, H. Maruiwa, M. Watanabe, and K. Hirabayashi, “Segmental motor paralysis after expansive open-door laminoplasty,” Spine, vol. 27, no. 19, pp. 2108–2115, 2002.
[35]
K. Hasegawa, T. Homma, and Y. Chiba, “Upper extremity palsy following cervical decompression surgery results from a transient spinal cord lesion,” Spine, vol. 32, no. 6, pp. E197–E202, 2007.
[36]
K. Sasai, T. Saito, S. Akagi, I. Kato, H. Ohnari, and H. Iida, “Preventing C5 palsy after laminoplasty,” Spine, vol. 28, no. 17, pp. 1972–1977, 2003.
[37]
K. Yonenobu, K. Okada, and T. Fuji, “Causes of neurologic deterioration following surgical treatment of cervical myelopathy,” Spine, vol. 11, no. 8, pp. 818–823, 1986.
[38]
Y. Hatta, T. Shiraishi, H. Hase et al., “Is posterior spinal cord shifting by extensive posterior decompression clinically significant for multisegmental cervical spondylotic myelopathy?” Spine, vol. 30, no. 21, pp. 2414–2419, 2005.
[39]
N. Tsuzuki, R. Abe, K. Saiki, and L. Zhongshi, “Extradural tethering effect as one mechanism of radiculopathy complicating posterior decompression of the cervical spinal cord,” Spine, vol. 21, no. 2, pp. 203–211, 1996.
[40]
S. Hukuda, M. Ogata, T. Mochizuki, and K. Shichikawa, “Laminectomy versus laminoplasty for cervical myelopathy: brief report,” Journal of Bone and Joint Surgery, vol. 70, no. 2, pp. 325–326, 1988.
[41]
L. Gonzalez Feria, “The effect of surgical immobilization after laminectomy in the treatment of advanced cases of cervical spondylotic myelopathy,” Acta Neurochirurgica, vol. 31, no. 3-4, pp. 185–193, 1975.
[42]
G. R. V. Kumar, G. L. Rea, L. J. Mervis, and J. M. McGregor, “Cervical spondylotic myelopathy: functional and radiographic long-term outcome after laminectomy and posterior fusion,” Neurosurgery, vol. 44, no. 4, pp. 771–778, 1999.
[43]
R. C. Huang, F. P. Girardi, A. R. Poynton, and F. P. Cammisa, “Treatment of multilevel cervical spondylotic myeloradiculopathy with posterior decompression and fusion with lateral mass plate fixation and local bone graft,” Journal of Spinal Disorders and Techniques, vol. 16, no. 2, pp. 123–129, 2003.
[44]
J. K. Houten, P. R. Cooper, E. C. Benzel, V. K. H. Sonntag, V. C. Traynelis, and U. Batzdorf, “Laminectomy and posterior cervical plating for multilevel cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament: effects on cervical alignment, spinal cord compression, and neurological outcome,” Neurosurgery, vol. 52, no. 5, pp. 1081–1088, 2003.
[45]
K. Miyazaki, K. Tada, Y. Matsuda, M. Okuno, T. Yasuda, and H. Murakami, “Posterior extensive simultaneous multisegment decompression with posterolateral fusion for cervical myelopathy with cervical instability and kyphotic and/or S-shaped deformities,” Spine, vol. 14, no. 11, pp. 1160–1170, 1989.
[46]
P. A. Anderson, P. G. Matz, M. W. Groff et al., “Laminectomy and fusion for the treatment of cervical degenerative myelopathy,” Journal of Neurosurgery, vol. 11, no. 2, pp. 150–156, 2009.
[47]
R. G. Spurling and W. B. Scoville, “Lateral rupture of cervical intervertebral disc. A common cause of shoulder and arm pain,” Surgery, Gynecology & Obstetrics, vol. 798, pp. 350–358, 1944.
[48]
R. B. Cloward, “The anterior approach for removal of ruptured cervical disks,” Journal of Neurosurgery, vol. 15, no. 6, pp. 602–617, 1958.
[49]
R. B. Cloward, “Vertebral body fusion for ruptured cervical discs. Description of instruments and operative technic,” The American Journal of Surgery, vol. 98, no. 5, pp. 722–727, 1959.
[50]
G. W. Smith and R. A. Robinson, “The treatment of certain cervical spine disorders by anterior removal of the intervertebral disc and interbody fusion,” Journal of Bone and Joint Surgery, vol. 40, pp. 607–624, 1958.
[51]
R. F. Heary, T. C. Ryken, P. G. Matz et al., “Cervical laminoforaminotomy for the treatment of cervical degenerative radiculopathy,” Journal of Neurosurgery, vol. 11, no. 2, pp. 198–202, 2009.
[52]
R. A. Davis, “A long-term outcome study of 170 surgically treated patients with compressive cervical radiculopathy,” Surgical Neurology, vol. 46, no. 6, pp. 523–533, 1996.
[53]
G. R. V. Kumar, R. S. Maurice-Williams, and R. Bradford, “Cervical foraminotomy: an effective treatment for cervical spondylotic radiculopathy,” British Journal of Neurosurgery, vol. 12, no. 6, pp. 563–568, 1998.
[54]
S. E. Emery, M. J. Bolesta, M. A. Banks, and P. K. Jones, “Robinson anterior cervical fusion: comparison of the standard and modified techniques,” Spine, vol. 19, no. 6, pp. 660–663, 1994.
[55]
R. D. Fraser, “Interbody, posterior, and combined lumbar fusions,” Spine, vol. 20, no. 24, pp. 167–177, 1995.
[56]
I. P. Wright and S. M. Eisenstein, “Anterior cervical discectomy and fusion without instrumentation,” Spine, vol. 32, no. 7, pp. 772–774, 2007.
[57]
N. E. Epstein, “Anterior cervical diskectomy and fusion without plate instrumentation in 178 patients,” Journal of Spinal Disorders, vol. 13, no. 1, pp. 1–8, 2000.
[58]
J. C. Wang, P. W. McDonough, K. K. Endow, and R. B. Delamarter, “Increased fusion rates with cervical plating for two-level anterior cervical pas and fusion,” Spine, vol. 25, no. 1, pp. 41–45, 2000.
[59]
M. J. Bolesta, G. R. Rechtine, and A. M. Chrin, “One- and two-level anterior cervical discectomy and fusion: the effect of plate fixation,” Spine Journal, vol. 2, no. 3, pp. 197–203, 2002.
[60]
H. Koller, A. Hempfing, L. Ferraris, O. Maier, W. Hitzl, and P. Metz-Stavenhagen, “4- And 5-level anterior fusions of the cervical spine: review of literature and clinical results,” European Spine Journal, vol. 16, no. 12, pp. 2055–2071, 2007.
[61]
J. R. McConnell, B. J. C. Freeman, U. K. Debnath, M. P. Grevitt, H. G. Prince, and J. K. Webb, “A prospective randomized comparison of coralline hydroxyapatite with autograft in cervical interbody fusion,” Spine, vol. 28, no. 4, pp. 317–323, 2003.
[62]
H. M. Heneghan and J. P. McCabe, “Use of autologous bone graft in anterior cervical decompression: morbidity and quality of life analysis,” BMC Musculoskeletal Disorders, vol. 10, no. 1, article 158, 2009.
[63]
W. C. Jacobs, P. G. Anderson, J. Limbeek, P. C. Willems, and P. Pavlov, “Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease,” Cochrane Database of Systematic Reviews, no. 4, Article ID CD004958, 2004.
[64]
S. Komura, K. Miyamoto, H. Hosoe, et al., “Lower Incidence of adjacent segment degeneration after anterior cervical fusion found with those fusing C5-6 and C6-7 than those leaving C5-6 or C6-7 as an adjacent level,” Journal of Spinal Disorders & Techniques. In press.
[65]
A. Katsuura, S. Hukuda, Y. Saruhashi, and K. Mori, “Kyphotic malalignment after anterior cervical fusion is one of the factors promoting the degenerative process in adjacent intervertebral levels,” European Spine Journal, vol. 10, no. 4, pp. 320–324, 2001.
[66]
A. S. Hilibrand, G. D. Carlson, M. A. Palumbo, P. K. Jones, and H. H. Bohlman, “Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis,” Journal of Bone and Joint Surgery, vol. 81, no. 4, pp. 519–528, 1999.
[67]
J. Goffin, A. Casey, P. Kehr et al., “Preliminary clinical experience with the bryan cervical disc prosthesis,” Neurosurgery, vol. 51, no. 3, pp. 840–847, 2002.
[68]
R. V. Botelho, O. J. dos Santos Moraes, G. A. Fernandes, Y. dos Santos Buscariolli, and W. M. Bernardo, “A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration,” Neurosurgical Focus, vol. 28, no. 6, pp. 1–11, 2010.
[69]
E. Wada, K. Yonenobu, S. Suzuki, A. Kanazawa, and T. Ochi, “Can intramedullary signal change on magnetic resonance imaging predict surgical outcome in cervical spondylotic myelopathy?” Spine, vol. 24, no. 5, pp. 455–462, 1999.
